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Executive functions disorders in children with frontal and temporal epilepsy

Amanda Guerra1, Rafika Fliss2, Mélodie Campiglia3

  • 1Univ Angers, Nantes Université, LPPL, SFR CONFLUENCES, Angers, France; Santos Dumont Institute (ISD), Macaíba, Brasil.

Epilepsy & Behavior : E&B
|November 15, 2024
PubMed

Insights

Children with focal epilepsy often experience executive functions (EFs) deficits, impacting daily life. This study highlights significant EFs impairments in frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE) patients, underscoring the need for targeted interventions.

Area of Science:

  • Pediatric Neurology
  • Neuropsychology

Background:

  • Children with focal epilepsy frequently exhibit executive functions (EFs) deficits, which can lead to adaptive challenges and negatively affect academic performance.
  • Executive functions are crucial cognitive processes that enable goal-directed behavior, including planning, working memory, and inhibition.

Purpose of the Study:

  • To investigate the executive functions profiles in children diagnosed with frontal lobe epilepsy (FLE) or temporal lobe epilepsy (TLE).
  • To examine the influence of medical and sociodemographic factors on executive functioning in these children.
  • To compare executive functioning as measured by performance-based tests versus rating scales.

Main Methods:

  • Executive functions were assessed using the Child Executive Functions Battery (CEF-B) performance-based tests.
  • Parent and teacher ratings of executive functions were collected using the Behavior Rating Inventory of Executive Function (BRIEF).
  • Fifty children (aged 6-16 years) with FLE (n=28) or TLE (n=22) participated.

Main Results:

  • Approximately 30% of children with FLE and TLE demonstrated significant EFs deficits compared to normative data.
  • Deficits were observed across inhibition, working memory, flexibility, and planning domains, with most patients affected in one or two domains.
  • Worse executive performance correlated with older age, longer epilepsy duration, higher seizure frequency, earlier onset, and more anti-seizure medications. Significant discrepancies were found between performance-based and rating measures.

Conclusions:

  • Children with FLE and TLE exhibit significant executive deficits, validating the clinical utility of the CEF-B.
  • The low agreement between performance tests and daily-life questionnaires indicates their complementary roles in assessing executive functioning.
  • Comprehensive assessment and tailored interventions are recommended for children with focal epilepsy to address executive functioning difficulties.
Abstract

Keywords:
Everyday lifeExecutive FunctionsFrontal Lobe EpilepsyPerformance-based testsTemporal Lobe Epilepsy

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